Before and after left breast reduction-pattern mastectomy and immediate implant reconstruction in a 52 year old woman. She had very heavy and pendulous breasts and required a mastectomy for left breast cancer after a large lumpectomy had positive margins. Although she was a candidate for a flap reconstruction, she chose to have an implant reconstruction on the left and a balancing breast reduction on the right.
Her mastectomy was done via breast reduction incisions. A smooth, round, adjustable saline implant was placed on top of the chest muscle, in the prepectoral position. No additional product such as ADM (acellular dermal matrix) was used.
Her implant was fully inflated at the time of the mastectomy; the implant port was left in place to allow for fine-tuning of the implant fill volume as needed after surgery. Her left nipple and areola was saved and reapplied to the left breast reconstruction as a free graft at the end of the surgery.
Because her permanent adjustable implant was placed in the space formerly occupied by her breast tissue and required no painful muscle stretching, she achieved her final reconstruction on the operating room table! She took only plain Tylenol for postoperative discomfort and returned to work 6 weeks afterward with no restrictions.
A balancing breast reduction was performed on the right side at the same time. Follow up images are shown at one month after surgery. She is nearly ready to start scar therapy. Fortunately, she did not require any chemotherapy (aside from hormone therapy) or radiation.
Her breast implant port will be removed in the office under local anesthesia in another couple of months, to complete her breast reconstruction with only one trip to the operating room.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
